Facts You Should Know About Mirena Birth Control

 

Intrauterine devices (IUDs) have grown in popularity and are now used as primary birth control by nearly 10 percent of U.S. women.

If you are thinking about trying out Mirena, one of two IUDs sold in the United States, you should first learn the facts about this device. It is convenient, but it comes with a risk of serious side effects like device migration, device expulsion, pelvic inflammatory disease and ectopic pregnancy.

1.  Why women choose Mirena.

Finding a birth control option that meets your needs can be difficult. Mirena offers convenience, as it prevents pregnancy without requiring users to take daily pills at specified times.  Also, with birth control pills, skipping doses can result in an unplanned pregnancy.

Once a health care provider implants the T-shaped, polyethylene plastic device into the uterus, it slowly releases a progestin birth control hormone and can remain in place for up to five years.

The device provides long-term birth control and is more than 99 percent effective in preventing pregnancy.

2.  Mirena can migrate within the body.

One of the most serious side effects associated with Mirena is migration. The device can move from its original position in the uterus and can perforate (or puncture) the wall of the uterus and damage the bladder, blood vessels, abdominal cavity and pelvis.

If Mirena migrates, a physician must locate the device and remove it during an operation, to protect organs and prevent pain and infection.

Women suffering from side effects like device migration have filed lawsuits against Bayer, the manufacturer of Mirena.

3.  Mirena can come out on its own.

The most prevalent side effect experienced by Mirena users also occurs as a result the device moving out of place. Device expulsion occurs when Mirena comes out on its own, spontaneously leaving the body through the vagina.

When the device comes out, women may experience cramping and bleeding, as well as pain during sexual intercourse.

Without the device in place, women are once again able to get pregnant, so back-up birth control becomes necessary. Patients will need to see a physician to either have a new IUD implanted or consider other options.

4.  The device can cause other serious side effects.

Women using Mirena also may suffer from pelvic inflammatory disease (PID), which can result in permanent damage and infertility. PID is a bacterial infection that can damage the uterus, fallopian tubes and ovaries. The condition may occur as early as three weeks after Mirena is implanted. According to the FDA, women who have a history of PID should refrain from using Mirena.

Although most Mirena users do not get pregnant, on the rare occasions when pregnancy does occur, women may experience septic abortions — which occur when a uterine infection results in septic shock and miscarriage. Women can also experience ectopic pregnancies, which is a pregnancy that grows outside of the womb. Half of the pregnancies experienced by Mirena users are ectopic, which cannot survive and often require surgery.

Alanna Ritchie is a content writer for Drugwatch.com, specializing in news about prescription drugs, medical devices and consumer safety.

References:

Food and Drug Administration. (2000, February 2). Mirena Executive Summary. Retrieved from www.accessdata.fda.gov/drugsatfda_docs/nda/2000/21-225.pdf_Mirena_Medr.pdf

Bayer. (2013, February 8). Important safety information about Mirena. Retrieved from http://www.mirena-us.com/having-mirena-placed/make-an-appointment-with-mirena.jsp

Boortz, H.; Margolis, D.; Ragavendra, N. & Katell, D. (2012, March). Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics, 32 (2): 335-52. doi: 10.1148/rg.322115068

Bayer HealthCare Pharmaceuticals. (2009, October). Mirena. Retrieved from http://labeling.bayerhealthcare.com/html/products/pi/Mirena_PI.pdf

Fall veggie recipes to enjoy!

These were from my first Sisters Midwifery Cooking class back in fall of 2007.  I had about a half-dozen clients back then and had attended about 70 births as a midwife or student midwife.  I’ve attended more than 200 births since, most of them as the primary midwife after spending many hours in the company of each client, getting to know her needs and those of her family.  It has been a rich experience & I’ve savored every moment!

I hope you enjoy these recipes.  They are all vegetarian and have vegan adaptations. Happy Autumn!

Lentil Soup

Ingredients:

1 tablespoon olive oil

2 cups dried green lentils

4 + cups of water

2 garlic cloves

½  medium white or yellow onion

1-2 fresh red tomatoes

2 large carrots

2 celery stalks

1 cup fresh spinach

1 teaspoon cumin powder (optional)

1 bay leaf (optional)

Braggs Amino Acids or tamari or sea salt

fresh plain goat or cow or soy yogurt

Directions:

Saute chopped onions and minced garlic in olive oil until onions are transparent.  Add crushed bay leaf, cumin, water, and lentils.  Bring to a boil.  Add chopped carrots and celery.  Let simmer, stirring occasionally until done (about 1 hour).  Salt to taste.  Add chopped tomatoes, fresh spinach and a scoop of yogurt to top.  Serve with seasonal salad and a whole wheat rustic loaf or corn bread (see recipe below).

Corn Bread

Ingredients:

1 cup unbleached, spelt or whole wheat flour ( ½   cup of each also works well, lighter than whole wheat alone)

1 cup corn meal

1 teaspoon salt

4 teaspoons baking powder

1 cup milk (soy also works well)

½ stick of butter (1/4 cup safflower oil also works well)

½ cup honey or maple syrup (rice syrup or ¼  cup of sugar also works well)

2 eggs (this recipe works alright without eggs, but will be crumbly)

Instructions:

Mix dry ingredients thoroughly

Mix butter, milk, honey

Add eggs to wet ingredients

Mix wet & dry ingredients

Pour into buttered (or oiled) medium-large iron skillet or glass baking dish

Bake at 425 degrees Fahrenheit for 20-25 minutes.  Slice and serve hot.

Fall Salads

Get creative with your salads by looking for the freshest produce and complimenting with nuts and homemade dressings.

Here are some ingredient ideas:

Fresh spinach

Mixed lettuces

Chopped red cabbage

Grated beets

Grated Carrots

Thinly sliced apples

Sliced pears

Dried fruit:  raisins, cranberries, or dried apricots

Nuts:  pecans, walnuts, cashews, or almonds

Seeds:  sesame, sunflower, or pumpkin

Tahini Dressing

½ cup tahini

juice of one lemon

1 clove minced garlic

½ cup water

salt to taste using sea salt, shoyu or tamari

Mix all ingredients thoroughly in blender.  Serve immediately.

 

Guest Blog Post

Raising Awareness about Pelvic Organ Prolapse Treatment Options

Despite the fact that pelvic organ prolapse (POP) is an extremely common problem, it is one that many women don’t know much about. A lot of women who are diagnosed with POP may have never heard of it until it happened to them, while others who suffer its symptoms aren’t diagnosed at all. The symptoms of POP can be embarrassing, so some just don’t speak about them to anyone, including their doctors. Others just accept them as the consequences of having children or aging, not realizing that there are treatments that can help.

Unfortunately, when women do seek help with POP symptoms, doctors may suggest surgery. While surgery may be necessary for some, it is not without risk, and there are other options. That is exactly why raising awareness about POP is important, so that women who experience it can make informed decisions about their care. Women should learn about POP symptoms and treatment options, then pass that information along to family and friends. Chances are pretty good that some of them really need to know.

Pelvic Organ Prolapse

POP is a pelvic floor disorder that occurs in about half of women who have had children. It is caused by weakening and stretching in the pelvic floor, which is the support structure that keeps pelvic organs in their proper places. POP happens when the pelvic floor becomes so compromised that organs drop down in the pelvis and put pressure on the vagina.

Symptoms can include pain or pressure in the area, a persistent feeling of fullness in the pelvis, vaginal bleeding or spotting, urine leakage and problems with bowel function. A noticeable bulge may develop in the vaginal area, and some women may see tissue protruding from the body. The biggest risk factors are pregnancy and childbirth. Other risk factors include obesity, heavy lifting, a chronic cough and constipation.

Non- Invasive Treatments

Kegel exercises can be very effective in reducing the symptoms of pelvic organ prolapse, since they strengthen and tone the pelvic floor. However, Kegels offer the best results when they are done with the instruction and guidance of a physical therapist, since biofeedback and other advanced tools can be used.

If you are overweight, losing those extra pounds can help reduce pressure on the pelvic floor. Preventing constipation is important, since it can worsen symptoms. Many women find that using a pessary makes them much more comfortable, which is a device that can be inserted into the vagina to support prolapsed organs.

Surgery

While many find relief in non-invasive alternatives, women with severe symptoms may require a surgical solution. However, it is very important for women to be well-informed on the options available, since some are riskier than others.

POP procedures that include the use of transvaginal mesh implants have been at the center of controversy for several years due to high rates of serious complications, which has prompted Food and Drug Administration (FDA) safety alerts and increased scrutiny of these devices. Common problems include mesh erosion, protrusion through vaginal walls, mesh shrinkage and organ perforation. Because of these complications some patients have started filing transvaginal mesh lawsuits to help treat them. So if surgery has been recommended for you, be sure to ask your doctor about procedures that do not use transvaginal mesh.

Author Bio:Elizabeth Carrollton writes about defective medical devices and medication safety for Drugwatch.com.

It’s Summer- Time to Juice!

This is my creation on Memorial Day 2012- a delicious blend of vegetables with fresh spices: garlic and ginger, along with salt and black pepper to taste

This compost will be added to my garden to increase nutrients in my organic beds come fall.

Get the best nutrients from your raw food by juicing what’s left each week in your fridge.  Weekly juicing will not only give you a chance to creatively pull together all of your left over produce from the week, but will also give you a big energy and nutrient boost!

Most people enjoy citrus juice, but while oranges, grapefruits and lemons are easy to squeeze, they are by no means the most seasonal produce for summer.  Choose instead veggies from your garden, your local farmer or your latest trip to the grocery store.  Seasonal fruits in summer include berries, peaches and other sensually pleasing sweets that are easy to devour with just a quick rinse.  It’s a shame to juice a delicious berry and miss the joy of texture and chew.  When juicing in summer, choose foods that are convenient and, whenever possible, seasonal and organic for the best taste.

There are two excellent juicers available for vegetable juicing. You can use these juicers for fruits as well, but citrus juicing may require an extra attachment.  Today, most folks are into the Vitamix http://vitamix.com/ .  The benefit of this juicer is the pulp.  Some raw foodists and nutrition geeks enjoy drinking the entire vegetable, including the fiber.    Others enjoy the Champion juicer http://www.championjuicer.com/ .  This juicer produces a filtered juice more similar to that which we have been accustomed to consuming from a can or jar at the store, but with the fresh organic produce that you select.

I’ve been using a Champion juicer since 1997, and I love it!  I’m not opposed to the Vitamix, but I was given a Champion and have used it with enthusiasm for fifteen years without having to replace a single part.  To me, that is the mark of a quality product.  The Champion costs upwards of $250 today, and the Vitamixers are around $400.  Research and choose carefully the right juicer for you.  You’ll likely only need one quality juicer in your household for decades.

Today I made a wonderful juice with all the left over veggies from my trip to the farmer’s markets this week, as well as other veggies that accumulated from previous trips to the grocery store.  I had an ageing head of broccoli, two gorgeous enormous heirloom tomatoes from Springdale farm, a quarter of a red cabbage, 10-12 large carrots, several celery stalks with leaves, 2 cloves of garlic, and a small cut of fresh ginger.  I washed everything well, scrubbing the carrots thoroughly.  Then I cut off the undesirable parts of the produce-woody ends and browning spots.  Then to the humming of my shiny juicer, I made a gallon of juice in about 6 minutes.  I poured the juice through a filter into my pitcher and added the juice of one lemon along with some salt and pepper to taste.  After stirring with a whisk, I served the juice.

The instant gratification of freshly made juice is tough to beat-so many fresh flavors intertwined into one swig!  After chilling, the beverage is even more delightful when served on a hot afternoon.  I know I’m giving my family and I a load of veggies, and that the pulp and discarded ends end up in my compost pile and then return to the cycle of life of my garden.  There is great long-term satisfaction in that process!

Just listening, and humming (or rocking)

One of the main arts of midwifery is the art of listening.  I’ve written about this topic before, but I come back to it everyday in my practice.  I listen to moms when they’re in labor.  I listen to their physical discomforts, their worries, their joys.  I listen to their partners express gratitude, concern or confusion.  Listening allows me to be fully present with my clients and to learn from them.

So much of the time, thoughts bounce around in our heads, and some of them aren’t helpful.  When we listen to our clients, we allow them an opportunity to purge their thoughts, to have them mirrored, and to refute or affirm them.  This is a sacred act.  Really listening to someone is so important, as it is important for each of us to be heard.

Active listening involves eye contact, body mirroring, affirming nods or comments.  It involves repeating what someone has said so that you can give them a chance to clarify, confirm or change their message.

The content of the words is important, and the body language is even more so.  Watching how a client holds herself:  her posture, her limbs and her gaze can give you insights into her feelings and deepen your understanding of her words and actions.

See if you notice the next time someone is really listening to you.  Notice how it feels to be attended to.  Practice it yourself.  It takes work, and we can’t always practice perfectly.  Awareness is the first step towards listening.  Be aware of your listening habits.  Try not to be too tough on yourself.  Try to engage in active listening. See how it feels.  See how it makes others feel who you attend to.  I’m working on this now, still.  Someday I hope to be a good listener to all.

Beekeeping and Midwifery

What can beekeeping teach me about being a midwife?  I’ve thought about this over the years, as I began these two paths around the same time in my life-my mid-thirties.  In my previous profession as an educator, I worked with people of all ages.  I taught preschool and college, from exercise fitness to psychology, ‘creative movement’ for children to ‘effective learning’ for adults.  My private full-time preschool was aptly named Imagination School, for that is how I approach learning, creatively.  Over ten years of teaching at a community college, I learned quite a bit about what excites the neurons of young adults, and it’s much the same, creative engagement.  Csíkszentmihályi called it ‘Flow’, or the total engagement and sense of timelessness that one experiences when tasks are just challenging enough and you’re in a motivational state.
I saw the same in my own two daughters and their peers when I taught them in homeschool settings.  We indulged in this special state of intrinsic learning for many years-my youngest was home through fifth grade, and my oldest from second through eighth.  I cannot begin to express the joy in watching your kids develop at their own pace in a manner that supports their very natures, allowing their interests to guide the subject matter, depth and direction of study.  Alas, in-depth homeschooling is not in alignment with a full-time midwifery career, so my kids went to school, where they continue to thrive.  It is my hope for them that they continue to be engrossed by active engagement in a highly motivated state doing something that they love.

Fortunate as I am, my work allows me this pleasure, as does beekeeping.  In these two arenas, I must stay grounded as I approach my work with respect and an awe of creation.  I feel one with the universe, with God, and with my bees or my client.  The entire rest of the world is silent-abstract and distant as I approach my birthing mom or my queen bee and her colony.  In silent reverence, or with a gentle voice, I connect, offering reassurance and love; offering my skills only when needed and hands-off support for the natural processes to unfold.  I am lucid, observant and engaged.  This is a beautiful place to hold space-connected to the oneness of all in the natural cycles of life.  

Midwife Learns to Play-The InterPlay Way

I just had a great weekend workshop last week her in Austin from InterPlay.  Along with other health care professionals, I practiced and learned techniques to bring playful energy to my clinical practice and my personal life.  I’m so excited about the discovery, as I’ve always valued sacred play in children, and now I’m delighted to know that play is sacred for adults, too.

The workshop was led by one of the founders of InterPlay, Cynthia Winton-Henry, a therapist and dancer.  She provided guidance and a safe play space.  We partook in silly activities, like babbling, and storytelling, movement and games.  We learned some of the most basic applications of InterPlay principles to our health care practices.  As what they term “recovering serious people”, it’s important for us to remember to bring levity and fun into our interactions with our clients.

Don’t expect rubber noses or face paint, but I think you will see the changes that this practice is having on me as a midwife.  It’s certainly affecting my interactions with family and friends.  It is my hope to create safe play space in my client activities to enrich my client’s experiences of motherhood and community in their childbearing years and beyond.

So after you read this blog post, I ask you to do something fun, something non-productive-just because.  Go draw a picture or turn on some ’80s music and dance;  build a sand castle or make playdough.  Do something just for the sake of fun, and see what happens.  I’ll keep you updated as to the changes I see that come from this practice.  For more information about InterPlay, go to their home page:  http://www.interplay.org/index.cfm/go/home:home/

Move your body

During pregnancy, many moms forget to move.  Especially during discomforts of the first trimester, fatigue and nausea may lead some moms to limit their exercise routine.  This is counterproductive, as movement often improves aches and pains common to pregnancy and uplifts one’s mood.  Exercise is essential for a healthy pregnancy.

If a mom wasn’t exercising before pregnancy, it may be challenging to incorporate movement into her daily life.  However, moms who exercised prior to conception may continue their current exercise routine if:  there are no contraindications specific to their pregnancy (discuss this with your care provider), and the routine exercise does not include prolonged periods of increased body heat (such as hot yoga, sauna, or hot tub).  While you may be able to continue your exercise routine in pregnancy, it is essential that you consume ample amounts of water to avoid dehydration, which can cause complications with your pregnancy.

If you haven’t been active, then starting a moderate exercise program in pregnancy is appropriate unless your care provider has informed you otherwise.  Walking, yoga and swimming can begin at any point in pregnancy, and are beneficial additions to any exercise routine during pregnancy.

Walking increases oxygen flow throughout the body, including the placenta, which transports oxygen to the baby.  When we walk, we loosen up tight areas in our musculature that may cause discomfort otherwise.  Walking provides an excellent mental health boost, especially when walking in nature or with a companion.  Our practice incorporates weekly 3-mile walks around Lady Bird Lake.  Moms enjoy the social support that the walks provide, and they enjoy the improvement to their overall sense of well-being.

In the summer months, we meet clients at a local public swimming pool for weekly swims.  When we swim, our bodies are buoyant, allowing us to relax and surrender areas of tension to flotation.  Swimming increases oxygen flow to the body, and it promotes rhythmic breathing that is helpful in childbirth.  When we swim breast-stroke or free-style, our babies rotate into an optimal position for birth, so swimming is especially helpful for birth preparation.

Whether you choose to walk, swim, or continue a spin class, yoga will offer unique benefits to your pregnancy.   Contrary to popular belief, yoga can be done at anytime and anywhere.  If you are a beginner, you may choose to attend a class or rent a video to learn basic yoga breathing, movement and postures that are appropriate for pregnancy.  If you have been a yogi for years, take time to learn about pregnancy yoga, for there are some important restrictions  that you need to take into consideration.  A good pregnancy yoga class will include ample time to sit, breathe and connect with your baby.  Yogic breathing is useful during all stages of labor, and it also assists new parents to remain calm when comforting a fussy baby.  At Sisters Midwifery, we usually have a yoga class scheduled, but these are not always available.  Many local yoga studios offer prenatal classes, so you will likely be able to find a class that is convenient for your needs.

Get out and move your body, connect with your breath and your baby.  Spring is coming, so indulge in long walks with your dog or partner; breathe the clean fragrant air and improve oxygen flow to your body.  If there is a pool or a yoga class offered nearby, give these physical activities a try, as well.  Dance classes, martial arts and other options may be available in your area.  Prioritize your exercise time so that you can enjoy a healthy active pregnancy.

Some things are worth the work!

It has been three-and-a-half years since Sisters Midwifery was born, and in that time, somethings have remained constant, while others have changed.  For example, when I first started my practice, we had a scattering of clients, as do most new clinicians.  Now Sisters Midwifery has two midwives and a full practice.

We are fortunate to serve so many wonderful families and witness their journeys in becoming new parents.  The addition of gifted midwife Christy Tashjian to the practice has been a wonderful expansion of our services.  Christy and I attended an inspiring primigravida (first time mom) twin birth  in August.  That experience, along with a few years of assisting each other at births, helped us to see our compatibility as partners.  Developing the practice to accommodate a new partner has been a lot of work for both of us, and it has created new challenges.  I’ve never collaborated in care as closely as I do now.  This endeavor is proving to be worth the work in many ways, especially in terms of the expanding services that we can offer, individually and collaboratively.

While big changes have been taking place, some of our best working practices have remained constant.  Individualized care, holistic expertise, active listening, childbirth education and client social support activities are among those.  The success of the client activities, in particular, has had delightful outcomes over these years.  Several of my clients have developed lasting friendships, and playdates, moms-day-out and other sweet social networks have spiraled out of the clients walks, childbirth classes, yoga classes and cooking classes.  These support activities have necessitated additional time outside of normal business hours for planning and attending these events, but the work has been joyful and productive in giving moms opportunities to make connections to others who are building and raising families.

When a mom smiles with confidence after learning a successful breastfeeding technique or an expectant dad expresses his vulnerabilities around taking on the role of father, I feel like I’m doing a good job at giving my clients opportunities to grow.  Each endeavor we take as human beings, whether we are starting a family or a midwifery practice, is a chance to grow and learn.  I find that the more work I put into supporting my clients and my new midwifery partner, the richer the experience is for all.  That’s what life is about anyway-growing and loving and witnessing these things.  Midwifery is hard work, but it’s results are worth it!

Seven Days in Haiti as a Midwife-Part 3: Bringing Haiti Lessons Home

With the tincture of time, I’ve been blessed with some perspective on my trip to Haiti and what it means for me now as a mother, midwife and world citizen.

In my family, Haiti is a lesson of appreciation.  I’m grateful that I know where my children are right now, that they are safe and well-nourished.  I know I am loved by my husband, and that he is a happy person free of worry about how to provide for his family.  From Haiti, I am re-learning how to appreciate my role as a mother and a partner, and enjoy the simple preparation of a meal for my loved ones.  I hope this will enrich my family life.

In my work, I’m learning to put women’s work into perspective.  The work of pregnancy, birth and becoming a mother are huge life-changing events.  In midwifery, we hold space for women to do their work while maintaining safe standards of care that are respectful of their autonomy.  My experiences volunteering in Haiti help me to see the problems of the women whom I serve here with more clarity, with empathy but detachment, as I can see their paths are theirs alone, and that I am simply a witness for their great work.  To take on more is not possible if one is to find the strength to work with women and their families daily.  Honoring the diverse paths of the women I serve is still my goal, but I feel that Haiti has made me stronger in my resolve to do so without attachment.  I hope this will serve my clients.

In my community, I found that true friendship and meaningful service are keys to happy engagement with others.  I’m spending more time with a select few friends, rather than spreading myself too thin or cutting moments in their presence too short.  I’ve become more discriminating, too, in my community service-searching for projects where I can invest my time while enjoying others and learning about myself.

In short, I’m learning from my teacher, Haiti, how to live a happier life, free of needless worry that originates from fear.  Seeing hardship close-up, alongside resilience, has given me this gift of insight that I hope will continue to grow.  I nurture it with careful reflection and thoughtful action.  Thank you, Haiti, for showing me my limits, teaching me to honor them and carefully choose when to push on to new ground.